Catheter Ablation for the Treatment of Atrial Fibrillation Have We Been Targeting the Wrong Organ?⁎

When I think back on my decision to pursue a career in cardiac electrophysiology,I recall how much I enjoyed this field in which almost every disease state and its specific treatment seemed logical. I was fascinated by the physiology of electrophysiology,how arrhythmias were generated,and how an understanding of pathophysiology led to curative procedures. I recall the joy of my first catheter ablation of an accessory pathway,how the surface electrocardiogram normalized within seconds of applying radiofrequency energy and,more importantly,how the supraventricular tachycardia that had plagued the patient for years was no longer able to be induced by pacing maneuvers. I remember the first day that I ablated an atrial tachycardia with a combination of activation mapping and pace mapping and how an almost incessant arrhythmia was silenced and sinus rhythm reigned. And I recollect feeling confident that the chance of recurrent atrial flutter was very low when I confirmed bidirectional block in another patient for the first time after a tricuspid isthmus ablation.
Journal of the American College of Cardiology Current Issue

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